Vitamin C
Place in Therapy
Vitamin C, also known as ascorbic acid, can be taken as a preventative measure for the recurrence of aphthous stomatitis. The studies assessed patients with recurrent aphthous stomatitis, although it was defined in different ways (eg. recurrent aphthous stomatitis patients had least one aphthous outbreak every 2 months for over 1 year vs another study examined patients with recurrent aphthous stomatitis occurrence 4 times or more during the previous year2) (1).
All studies had statistically significant results; reduction in frequency and severity of aphthous stomatitis1, may be deficient of vitamin C2 and increased in oxidative stress in RAS patients (3). However, these studies had many limitations and poor external validity, thus the true efficacy of vitamin c on recurrent aphthous stomatitis needs to be further studied with larger randomized control trials. In conclusion, patients can take vitamin C supplements since it has a good safety profile and to avoid deficiency and it may decrease oxidative stress and reduce frequency and severity of aphthous stomatitis(1)(2)(3).
References:
1. Yasui K, Kurata T, Yashiro M, Ohtsuki S, Morishima T. The effect of ascorbate on minor recurrent aphthous stomatitis. Acta Paediatr. 2010 Mar; 99(3): 442-445.
2. Ogura M, Yamamoto T, Morita M and Watanabe T. A case-control study on food intake of patients with recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Jan; 91(1):45-49.
3. Saral Y, Coskun BK, Ozturk P, Karatas F and Ayar A. Assessment of salivary and serum antioxidant vitamins and lipid peroxidation in patients with recurrent aphthous ulceration. Tohoku J Exp Med. 2005 Aug; 206(4):305-312.
4. LexiComp online. Ascorbic Acid. Wolters Kluwer Health. [Cited: 2013, July 11]. Available from: http://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/6386.
5. Beveridge C. Chapter 41. "Basic Nutrition." Patient Self-Care: Helping Your Patients Make Therapeutic Choices. Ottawa: Canadian Pharmacists Association, 2010. 366.
6. Office of Dietary Supplements. Vitamin C. National Institutes of Health. [Cited:2013, July 11]. Available from: http://ods.od.nih.gov/factsheets/VitaminC-QuickFacts/
7. MedlinePlus. Vitamin C (Ascorbic acid) [internet]. Natural Medicines Comprehensive Database. [Cited:2013, July 11]. Available from: http://www.nlm.nih.gov/medlineplus/druginfo/natural/1001.html.
8. Jamieson Natural Sources. Vitamin C. [Cited: 2013, July 11]. Available from: http://www.jamiesonvitamins.com/supplements
9. Webber Naturals. Vitamin C. [Cited: 2013, July 11]. Available from: http://webbernaturals.com/products/categories/1113/vitamin-c
10. Swiss Natural. Vitamin C. [Cited: 2013, July 11]. Available from: http://www.swissnatural.com/en/products/?reset=true&q=vitamin%20c
All studies had statistically significant results; reduction in frequency and severity of aphthous stomatitis1, may be deficient of vitamin C2 and increased in oxidative stress in RAS patients (3). However, these studies had many limitations and poor external validity, thus the true efficacy of vitamin c on recurrent aphthous stomatitis needs to be further studied with larger randomized control trials. In conclusion, patients can take vitamin C supplements since it has a good safety profile and to avoid deficiency and it may decrease oxidative stress and reduce frequency and severity of aphthous stomatitis(1)(2)(3).
References:
1. Yasui K, Kurata T, Yashiro M, Ohtsuki S, Morishima T. The effect of ascorbate on minor recurrent aphthous stomatitis. Acta Paediatr. 2010 Mar; 99(3): 442-445.
2. Ogura M, Yamamoto T, Morita M and Watanabe T. A case-control study on food intake of patients with recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Jan; 91(1):45-49.
3. Saral Y, Coskun BK, Ozturk P, Karatas F and Ayar A. Assessment of salivary and serum antioxidant vitamins and lipid peroxidation in patients with recurrent aphthous ulceration. Tohoku J Exp Med. 2005 Aug; 206(4):305-312.
4. LexiComp online. Ascorbic Acid. Wolters Kluwer Health. [Cited: 2013, July 11]. Available from: http://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/6386.
5. Beveridge C. Chapter 41. "Basic Nutrition." Patient Self-Care: Helping Your Patients Make Therapeutic Choices. Ottawa: Canadian Pharmacists Association, 2010. 366.
6. Office of Dietary Supplements. Vitamin C. National Institutes of Health. [Cited:2013, July 11]. Available from: http://ods.od.nih.gov/factsheets/VitaminC-QuickFacts/
7. MedlinePlus. Vitamin C (Ascorbic acid) [internet]. Natural Medicines Comprehensive Database. [Cited:2013, July 11]. Available from: http://www.nlm.nih.gov/medlineplus/druginfo/natural/1001.html.
8. Jamieson Natural Sources. Vitamin C. [Cited: 2013, July 11]. Available from: http://www.jamiesonvitamins.com/supplements
9. Webber Naturals. Vitamin C. [Cited: 2013, July 11]. Available from: http://webbernaturals.com/products/categories/1113/vitamin-c
10. Swiss Natural. Vitamin C. [Cited: 2013, July 11]. Available from: http://www.swissnatural.com/en/products/?reset=true&q=vitamin%20c